The pushback against Howard Dean for his call to "kill" the Senate health care bill, continued on Friday night, with a prominent Senate Democrat picking out an old quote from the former DNC chair's past to paint him as hypocritical in the debate.

Sen. John Kerry (D-Mass.) who squared off against Dean during the 2004 Democratic primary, issued the following statement on the Senate floor as the week-long debate over health care hit a closing crescendo:

I can promise you, if we follow that kind of advice and give up now, just because the bill is not all we want it to be, we surrender the very reforms that people have spent their lives working for, reforms that the Democratic Party has been proposing for decades, reforms that many of us in the Senate today ran on and promised we would work together to achieve.

What we are trying to do here is not easy. It wasn't easy for Franklin Roosevelt when he tried, it wasn't easy for Harry Truman when he tried, it wasn't easy for Bill Clinton when he tried. But you don't sound the retreat, especially when you are so close to achieving many of your objectives.

Some of our liberal friends have suggested we should kill the health care reform bill because it doesn't have a public option.

This week, for example, Howard Dean wrote in a Washington Post op-ed that real health care reform needed a public option that would '...give all Americans a meaningful choice of coverage.' I was surprised to read that because back in 1993, then-Governor Howard Dean called Medicare '...one of the worst federal programs ever and a living advertisement for why the federal government should never administer a national health care program.'

Well, I am a strong supporter of the public option and I've fought to see it included. But if it cannot be included, I'm not willing to walk away.

The remarks, which were offered under a press release titled "Kerry Rebuts Republicans on Health Care, Urges Democrats to See Bigger Picture," is yet another example of the growing divide between Democrats inside and out of office. The progressive community itself is torn on the politics and policy implications of health care reform. But what stands out is the willingness for Kerry, the White House and other Senators on the Hill to turn their guns on Dean even as they bite their tongues when it comes to conservative Democratic critiques of the legislation.

As one plugged in Democrat in the heat of the negotiations put it succinctly: "[Sen. Joseph] Lieberman (I-Conn.) has a vote in this process. Dean doesn't."

The effort to persuade Sen. Ben Nelson to end his threat to filibuster health care reform without tougher restrictions on abortion have resulted in an interesting role reversal: three Nebraska pastors are now urging the senator to support the bill.

Revs. Bert Thelen, S.J., Jane Florence and David Lux took to the pages of the Omaha World Herald on Friday in an op-ed that framed the need for health care reform as a moral imperative. The trio didn't address the issue of abortion directly. But their pleas to Nelson to help pass reform (and "ensure" his legacy in Nebraska) seem to indicate that Nelson should save his concerns over abortion for another day.

As Nebraska faith leaders, we call for systemic change that is guided by the following principles based on our religious values. We support universal access to good-quality health care that: (1) Provides comprehensive and affordable coverage for all. (2) Eliminates health care disparities. (3) Includes effective cost containment. (4) Simplifies administration. (5) Eliminates pre-existing condition exclusions from coverage.

We turn to U.S. Sen. Ben Nelson, knowing he stands with us as a person of faith. As governor, he left a lasting and important legacy of strong public insurance programs such as Kids Connection and CHIP, which provides insurance to thousands of Nebraskans who would otherwise join the uninsured.

Now we turn to him again to leave another legacy: health care for all Nebraskans. If we can fix the broken health care system, we can ensure that Nelson's legacy in Nebraska is continued with his vote this year to pass health reform.

We thank Sen. Nelson for continuing to make health care a priority for all Nebraskans and for leaving a legacy of healthy Nebraskans.

Considering how radioactive the issue of abortion is in this debate and overall, its seems likely that the three pastors are sticking their necks out a bit with this op-ed. That said, the Catholic Health Association -- which has about 20 hospitals in Nebraska -- has already endorsed abortion language in the Senate health care bill that falls short of the restrictive provision passed by the House. And so have have more than 30 pro-life Evangelical leaders including several National Association of Evangelicals board members.

Sen. Tom Coburn (R-Okl.) acknowledged the obvious on Friday, stating that the goal of his parliamentary shenanigans and the Republican Party as a whole is to "kill" the Senate's health care bill.

Appearing on a conference call with reporters organized by the Republican National Committee, Coburn said that, in the reverse situation, Democrats would deploy the same procedural tactics -- including demanding that the Senate read all 767 pages of an amendment, such as the single-payer amendment offered by Sen. Bernie Sander (I-VT).

"I don't think we are doing anything they wouldn't do," said the Oklahoma Republican.

But the most telling moment of the call came when a woman named Judith Erickson (spelling may not be accurate), who claimed to be from the RNC, was granted the chance to ask a question and ended up leveling a lengthy anti-Democratic diatribe.

"I have been an international sales director for a number of years and I am well aware of the populations in all these countries that supposedly the radical leftist want to make us mimic," she said. "You got to Scandinavian countries -- they have a few million in population and we are 300 million plus. I don't understand why anyone is even listening to people who say 'Oh, well they have this in other nations.' Excuse me. We are the largest nation that hasn't done this and it is all for good reason. My concern is, why isn't this entire thing being stopped? Just because it looks like right now the Democrats will say, 'OK, we will take out this, this, this and this.' And it is only to put the framework in place of their totalitarian utopia state, which means they are going to control everything and only give it to those who vote Democratically or force people who aren't voting Democratically to become Democrats. I mean it is a whole debacle and it is nothing about health care. Why aren't we just totally killing this bill, end of story?"

Coburn replied without missing a beat.

"Well," he said. "I think it's a good question. First of all, we are trying to kill the bill. But [there are] parliamentary rules... plus they have 60 votes, and in the Senate 60 votes is an absolutely majority and you can do anything you want to do. We have done a fairly good job highlighting the fact that they are going to steal a trillion dollars over the next ten years from Medicare."

The White House will play an active role in moving health care legislation closer to the House's version once a bill passes the Senate and goes to conference committee between the two chambers, administration officials said on Thursday. But while much of the progressive community is hoping for a renewed push to expand the government's role in providing insurance, the president will likely focus on other priorities.

White House health care czar Nancy-Ann DeParle told a conference call of progressive bloggers that there "are some things I'd like to improve" in the Senate's health care bill once legislators merge it with the House's legislation. The primary objective for the administration is to adopt the House's language on making insurance more affordable (which is more generous than the Senate's), she explained.

"I'd like to make some more changes there and move a little bit more towards the House bill," DeParle said. "So we'll see, I don't know what we'll be able to do there. But I know we talk daily to our friends and colleagues in the House who are just as anxious to get this done."

The White House also has its eyes on legislative language in the Senate bill that -- in the near term -- limits the amount of money private insurance companies can pay on medical coverage annually.

"Where we are right now is, we are still working with CBO to see if we can do something before the [state health care] exchanges starts," DeParle said. "But if not, it is going to be just no annual limits after the exchange starts which is where the House is."

The specificity of DeParle's remarks suggests that the administration will indeed amplify the role it's playing in the health care debate as lawmakers enter the final stage for revisions. After the Senate passes health care legislation, the two congressional chambers will send negotiators to a conference committee, where their respective bills will be fused together and sent back for a vote.

The president has, to this point, largely handed off control of the process to congressional negotiators. But since the Senate axed several major progressive priorities -- the public option and the expansion of Medicare -- pressure has mounted for Obama to step in forcefully.

"The question is now, when we're in a conference committee and the president can really put his finger on the scale, does he do it now?" Rep. Anthony Weiner (D-N.Y.) told MSNBC's "Morning Joe". "What we're saying is now is your moment, big guy. You're the Mariano Riviera of this situation: you're going to come in the end and there's still chance for them to do it."

"If you believe that there is no value to the bully pulpit of the president, then you haven't watched any big civic debates in this country in the last 50 years," Weiner added. "That's how big bills get done. I'm not saying it's always successful."

There is concern that the House will not be able to pass the Senate's version of health care reform without some tinkering. A public option for insurance coverage may not be re-inserted. But the labor community will demand that negotiators drop a tax on high-end health care plans (which covers many union members) in favor of a tax on the wealthy.

It will, in the end, be a delicate balance. But expect the president to play an active role.

"The president is fighting," said DeParle. "You have no idea how many hours, how many hundreds of hours he spent, how many phone calls he's made, how many meetings he's had. It still boils down to 218 votes in the House, and 60 votes in the Senate. That's what we have to have to pass it. And I love the House bill. They've done a terrific job. It was historic. It is wonderful but we won it by one vote over there, and now we're trying to rustle up 60 votes in the Senate."

One of the president's top advisers criticized Sen. Ben Nelson (D-Neb.) on Thursday for threatening to filibuster health care reform despite his record of opposing that parliamentary tactic in the past.

In a conference call with progressive bloggers, White House senior adviser David Axelrod urged Nelson to drop his demand for stricter abortion limits and let the bill come to a vote.

"We are working hard to persuade Senator Nelson that this is in the best interest of Nebraska and his constituents and the country. And we will continue to do that as we will with other members of the Senate," Axelrod said. "And the main thing I would say to him and others members of the Senate is that after a long, long, long and thorough debate, let us have a vote.

"What we are arguing about today is not whether a majority support the bill in the Senate," Axelrod added. "A majority does. What we are arguing about is whether they will have a chance to express themselves and vote -- or whether a minority will thwart the majority and keep that vote from happening.

"And so my hope is that for Senator Nelson, who has always said under Republican administrations that we shouldn't use procedural maneuvers to try and keep bills from coming to the floor, that he will not allow that to happen here."

The rebuke of Nelson on grounds of being hypocritical on cloture votes is normal fare for Democrats and progressives who long ago tired of the Nebraska Democrat's histrionics with regards to health care reform. But it is surprising coming from the Obama White House, which has been abundantly cautious not to offend critical swing senators.

Indeed, the administration's unwillingness to criticize either Nelson or Sen. Joseph Lieberman (I-Conn.) for threatening to derail reform was likely one of the reasons behind the conference call in the first place.

The White House, in recent days, has publicly admonished liberal critics (notably, former DNC Chair Howard Dean) for suggesting that the Senate's version of reform has been watered down too far to support. Press Secretary Robert Gibbs suggested that Dean was being irrational. And on Thursday morning, Axelrod called discussion of defeating a bill because it lacks a public option "insane."

Some progressive bloggers felt the White House was being too one-sided in its critiques. Asked whether Nelson, like Dean, was acting "insane" in wanting the bill killed over specific policy grievances, Axelrod replied:

I'm not professionally qualified to judge insanity. Maybe I should've used a different word. But let me tell you the basis from which I spoke. You know, this is to me not just a theoretical issue. This is a very personal one.

I've dealt with these issues myself in my life. I have got a child with a chronic illness. When I was a young reporter, we were in an HMO and my child got sick. And I ended up spending tens of thousands of dollars out of pocket that I didn't have. When I left that job I couldn't get insurance... I had to keep two policies. And the stress of that, getting her the treatment and the medication she needed, was extraordinary and difficult. And I know there are millions of people all over this country who are experiencing that. I see in these bills an opportunity to give help to those people so they are not in the position that I was in. So that is why. It wasn't just a about bending the curve. This is not just about dealing with the fiscal implications of the runaway costs of health care. This is about dealing with the human implications of a system that doesn't work very well.... That is the basis on which I reacted.

[snip]

We have this extraordinary moment when we can win where we never could win before. And that's the basis from which I used that word. I don't doubt the sincerity of people in this debate on all sides. And certainly people in the progressive community, I know, care deeply about rectifying the very problems I'm talking about. But these bills will go a long way toward doing that and that's why I feel so strongly about that.

The head of the most powerful union group in the country said on Thursday that the Senate version of the health care bill will not survive a vote in the House without substantial changes.

Richard Trumka, president of the AFL-CIO, told the Huffington Post that both he and his members are "extremely disappointed" with the compromises conservative Democrats extracted from Senate leaders. Rather than formally opposing the bill, he expressed confidence that it will change before passage

"If the Senate bill in its current form went to the House it would go down," he declared.

"I can tell you this," he added. "The plan as it currently is would not get much support from the American worker unless it is improved.

"So that is another line they are going to have to deal with. Speaker [Nancy] Pelosi I think will adequately represent everybody involved. And I think that is a better model for a bill."

In separate statements on Thursday, both Trumka and SEIU President Andy Stern expressed similar concerns with the Senate bill: That without a public option for insurance, and with a provision that taxes high-end health care plans that cover many union members, the bill doesn't create enough competition and lacks an equitable source of revenue.

There is a growing private consensus among union officials that they will have to give up hopes of expanded government-run insurance (if they haven't already) in exchange for replacing the Senate's revenue provisions with the one adopted by the House -- which relies on increasing taxes on the wealthy.

"A progressive tax structure is very, very important," said Trumka. "But so is a public option. And I'm not willing to negotiate right now and jettison any one of those because I think they are both important items.

"I'm not willing to declare [the public option] dead," he added.

Asked about the seeming willingness of progressive Democratic Senators Russ Feingold (Wisc.), Tom Harkin (Iowa) and Sherrod Brown (Ohio) to do just that, Trumka replied: "So what? So what?.... What are they saying in the House? Nancy Pelosi isn't saying this is dead, that's dead? Everything is dead? Has the House said that? No. There are two chambers involved here.... What I'm saying is we are not ready to stop fighting and we are going to improve this bill because it is inadequate as presently constituted."

Trumka repeatedly stressed that the union community is unwilling to take the consider the Senate bill a done deal. He noted that, as a union leader in the coal mines, he once got President George H.W. Bush to sign into law a health care package for his members. He also referenced his beloved Pittsburgh Steelers and Franco Harris's "Immaculate Reception" as a means of underscoring that the unexpected, last minute victory isn't necessarily impossible.

Notably, he refused to cast blame for the fate of the Senate bill either on the Democratic leadership (the White House included) or those conservative Democrats who demanded that the public plan be dropped. It was the Republican Party, unwilling to negotiate from the start, that roused his ire.

As for the obstinacy of Sen. Joseph Lieberman (I-Conn.), "I'm not even going to go there," Trumka said. "Seriously. I'm not going to go there. If you had 10 Republicans who were willing to be legislators, would [Lieberman or Ben Nelson] matter? So you want to point the finger. You point the finger at 40 senators who have said no to everything and offered nothing in its place."

Trumka did, however, suggest that while Democrats aren't fully responsible for the quality of the Senate bill, they could and will bear the brunt of the blame -- and electoral consequences -- should the legislation pass.

"If you tax the benefits of workers so that they have less health care," Trumka said, "I mean I would expect them to consider that when voting."

In less than two days time, the progressive action group MoveOn.org has raised more than $1 million for its campaign against Sen. Joseph Lieberman (I-Conn.).

The five-million-member group launched a fundraising drive on Tuesday after the Connecticut independent successfully killed key provisions from the Senate's health care reform legislation.

The goal was set, initially, for $400,000. By 1:22 p.m. on Thursday they were past the $1 million mark and climbing. The money will go to an ad campaign against Lieberman and into a fund to oppose his re-election in 2012.

The massive and quick response to the plea reflects just how much progressive frustration there is about the man who, eight years ago, was the Democratic vice presidential nominee.

Additionally, on Thursday, MoveOn.org put out a comic web ad using sock puppets to mock Lieberman as a spotlight-seeking political diva -- and his colleagues in the Democratic caucus as spineless enablers of his behavior.

The spot, which is not part of the broad multimedia ad campaign that the group will launch with its fundraising drive overhaul, has Lieberman at one point demanding that he be given four inches in height in exchange for his vote -- a request that was, naturally, granted.

Mockery of Lieberman may be one of the few sticks left to brandish in the health care reform debate. However. MoveOn's video seems more likely to make progressives feel better than to compel Democratic leadership to toughen up.

By giving in to Sen. Joseph Lieberman's (I-Conn.) demands on health care legislation, Senate Democratic leadership may have moved closer to blocking a Republican filibuster. But they've also made reform far less popular.

Lieberman's insistence that a government-run insurance option (as well as a provision to expand Medicare) be stripped from the bill has moved Democrats and the White House towards the wrong side of public opinion.

In a NBC/Wall Street Journal poll released on Wednesday, 45 percent of respondents said it was unacceptable to "no longer create a public health care plan administered by the federal government to compete directly with private health insurance companies". Only 42 percent said such a compromise was acceptable. Meanwhile, just 32 percent of people said the president's health care plan was now a "good idea" with 47 percent saying it was, in fact, a "bad idea" -- the highest percentage of detractors recorded.

"Most of the movement on the 'bad idea' comes from some of the president's core support groups, folks upset about lost public option," Chuck Todd, NBC political director and White House correspondent, tweeted.

The trickiest task facing Democrats going forward may be convincing the public that they should be required to purchase health insurance coverage but not have the option of getting it from the government. Months ago, the pro-reform group Health Care for America Now polled the individual mandate.

Sixty-four percent of national respondents said they opposed legislation "requiring everyone to buy and be covered by a private health insurance plan." Only 34 percent supported such a proposal. By contrast, 60 percent of respondents favored legislation "requiring everyone to buy and be covered by a health insurance plan with a choice between a public option and private insurance plans." Thirty-seven percent opposed such a plan.

The Senate, at the behest of one member, settled on the former and not the latter.

"The fact is what Lieberman has forced them to do is to take away one of the most popular provisions of the legislation, which is giving them the choice of the public option," said Richard Kirsch, national campaign manager at HCAN. "And our research has found that where a mandate is really unpopular without a public option it is quite popular with a public option."

The nation's largest union group said Thursday that it will not support the Democratic health-care bill unless "substantial changes" are made to the current Senate version.

AFL-CIO President Richard Trumka said in a statement to reporters that without a public option for insurance coverage or an employer mandate - and with a tax on high-end insurance plans that some union members get - the health care legislation supported by Senate Democrats falls far short of meeting his group's standards.

"[For] this health care bill to be worthy of the support of working men and women, substantial changes must be made," said Trumka. "The AFL-CIO intends to fight on behalf of all working families to make those changes and win health care reform that is deserving of the name."

The remarks are a strong indication that the coalition of pro-health-care-reform groups has begun to fray. Earlier in the day, Service Employees International Union President Andy Stern penned a letter to his fellow union members in which he called out President Barack Obama for abandoning his own principles of reform.

"President Obama must remember his own words from the campaign. His call of 'Yes We Can' was not just to us, not just to the millions of people who voted for him, but to himself. We all stood shoulder to shoulder with the President during his hard fought campaign. And, we will continue to stand with him but he must fight for the reform we all know is possible," Stern wrote.

"Our challenge to you, to the President, to the Senate and to the House of Representatives is to fight," Stern continued. "Now, more than ever, all of us must stand up, remember what health insurance reform is all about, and fight like hell to deliver real and meaningful reform to the American people."

Stern, like Trumka, called for Democrats to make changes to the legislation as the process moves forward. And his rebuke of Obama - a staunch personal ally - was a telling sign of the growing frustration within the labor movement.

Both labor leaders were particularly incensed over the concessions made by the Senate's Democratic leadership to Sen. Joseph Lieberman (I-Conn.), the 60th member of their caucus. "The public option is declared impossible. Americans cannot purchase Medicare at an earlier age. The health insurance reform effort we have needed for a century is at risk," Stern wrote.

Officials at both unions met late into the night on Wednesday in emergency sessions to discuss the Senate bill. Aides say the conversations were lengthy and, at times, emotional. The labor community, while privately angry with the White House and Democrats in Congress, still needs the support of these lawmakers on other legislative priorities. Meanwhile, having poured millions into advertisement and man-hours in order to get health care passed, they have watched in horror as the principles they worked for were abandoned in a matter of days.

Officials are also aware of how much would be lost by simply scrapping the bill altogether. Stern noted that under the Senate's bill 30 million additional people would be covered, pre-existing conditions would no longer be an excuse to deny coverage, and people who get sick would no longer lose their insurance. Trumka, likewise, pointed to "good things" in the Senate bill, including the fact that "insurance companies will no longer be able to deny coverage based on pre-existing conditions or impose lifetime or unreasonable annual limits."

On Wednesday, White House Press Secretary Robert Gibbs strongly hit back at former DNC Chairman Howard Dean for criticizing the Senate health care bill, suggesting, at one point, that Dean was being irrational and didn't understand the contents of the legislation.

"I don't know what piece of legislation he is reading," said Gibbs.

"I would ask Dr. Dean, how better do you address those who don't have insurance: passing a bill that will cover 30 million who don't currently have it or killing the bill?" he added. "I don't think any rational person would say killing the bill makes a whole lot of sense at this point."

Asked if Dean was acting irrationally, Gibbs replied: "I can't tell what his motives are, to be honest with you."

A prominent champion of the public plan, Dean has strongly criticized the recent round of compromises made by Senate Democratic leadership, in which the public option was axed and a provision to expand Medicare was also sacrificed. The former Vermont governor has called the current incarnation a give-away to the insurance industry because it won't effectively control the cost of premiums and would not create additional competition for the private market. Gibbs went through a list of Dean's complaints, rebutting them one by one. He also insisted that, during his run for the White House in 2004, Dean ran on a platform that resembled the current Senate bill.

"If this is an insurance company's dream, I think the insurance companies have yet to get the memo," he summarized.

In actuality, the insurance companies do seem to have considered the recent round of negotiations a victory, with one executive telling Ben Smith of Politico: "We win."

The relationship between Dean and the White House has been frosty, starting when the president did not pick the former DNC chair for the post of Health and Human Services Secretary. But the rhetoric from Gibbs on Wednesday brought the animus to a far more public level.

Asked if they are worried that Dean's criticism of the bill will sway progressives in the Senate, Gibbs replied: "No."

Asked if Dean was an irritant, Gibbs replied: "That is not a question for me to answer. I think if you look at what Sen. Tom Harkin (D-Iowa) and Sherrod Brown (D-Ohio) and others have said, I think they can point out the benefits of the legislation."

When White House Chief of Staff Rahm Emanuel implored Senate Majority Leader Harry Reid (D-Nev.) on Sunday to agree to demands to drop a provision to expand Medicare coverage, he was abandoning principles of health care reform that he once supported.

Back in November 2007, the then-Illinois Representative and head of the Democratic Congressional Campaign Committee penned an op-ed for the Washington Post in which he specifically vouched for the provision he now opposes.

Titled "Before We're 64", Emanuel and Bruce Reed, president of the moderate Democratic Leadership Council, wrote that allowing those as young as 55 to buy into Medicare was essential to relieve the financial burdens on American workers and businesses.

In 2005, Americans ages 55 to 64 were the fastest-growing segment of the population to become uninsured. For those employees lucky enough to still have insurance, the percentage of workers with deductibles of $500 or more has nearly tripled.

Covering early retirees is the most acute problem for workers and employers alike. Younger workers have fewer health needs and cost far less to cover; older retirees have much of their higher costs covered by Medicare. The average annual cost of covering a 30-year-old employee is $2,222. The average yearly cost for an employee who retires at 60 is $6,139.

We can't afford to let American workers and companies wither on the vine. We can ease the cost crunch for both by giving employers and unions a new option: buying Medicare coverage for retirees ages 55 to 64. Retirees would get quality care from a program they can trust. Employers would get to buy affordable insurance and take spiraling health costs off their books.

At the time, Democrats controlled Congress but not the White House. And the notion of enacting health care reform was tempered by the implicit recognition that you needed a president willing to do the heavy lifting. Emanuel, then and now, was considered a pragmatist above all else. But in writing about the benefits of a Medicare buy-in, he referenced virtually the same arguments that champions of the proposal have today: that it would alleviate costs on companies who provide health insurance to this age group without costing the taxpayers money.

Those points seem largely moot at this juncture of the current health care debate as Emanuel, the president and Democratic leadership in Congress have said they value the passage of legislation over any one particular provision. But the Washington Post op-ed remains a vivid illustration of how the current political system creates an inverse relationship between political power and policy passion. Emanuel, today, is in a far better place to enact the Medicare buy-in proposal. But he reportedly played the persuasive role in getting it sacrificed.

An amendment that would prevent the government from working with contractors who deny victims of sexual assault the right to bring their case in court has survived attempts to dull its impact and seems poised to become law.

The Senate Committee on Appropriation passed, on Tuesday, a defense appropriations bill that included the "anti-rape" amendment introduced by Sen. Al Franken (D-Minn.). The legislation was intended to address and prevent a recurrence of the assault and rape that Jamie Leigh Jones, a defense contractor for the company KBR, alleged was committed by her fellow employees. But the amendment became a subject of debate after the Department of Defense, Republicans in the Senate, and even the committee chairman, Sen. Dan Inouye (D-Hawaii) raised concerns that it would leave contractors over exposed to lawsuits.

The final product, in the end, proved remarkably strong. According to a Franken aide, the substance of the language "is unchanged." Under the amendment the government would not be able to do business with companies that deny court hearings for victims of either assault, false imprisonment, intentional infliction of emotional distress or negligent hiring practice. The controversial Title VII provision, which would allow victims of assault to sue the employers of the alleged perpetrator and not just the perpetrator himself or herself, remains in the bill. Meanwhile, the threshold at which companies will be subjected to the legislation is set at those who have contracts totaling $1 million or more.

All told, the legislation would affect all major and many minor contractors, forcing them to choose between allowing litigation for their employees or forfeiting the hundreds of millions in dollars that are doled out annually in contracts by the federal government.

The Franken amendment includes a national security waiver, meaning that the Department of Defense could circumvent the law if it is deemed dangerous to U.S. safety. But, for that to happen, the Secretary of Defense would have to "personally explain why the waiver was used to Congress and at that point make it public," the Franken aide explained.

"I came to Washington to stand up for folks like Jamie Leigh, and stand up to the powerful interests that too often silence their voices," Sen. Franken said in a statement. "I was gratified to see so many of my colleagues in Congress and so many national civil rights leaders join in this effort. The Jamie Leigh Jones amendment is on its way to becoming law thanks to their work, the work of Chairman Inouye, and the work of the White House. I'm pleased that together, we were able to find a solution that allows victims of assault and discrimination their rightful day in court."

The amendment was initially added to the defense appropriations bill on October 21, 2009 by a 68 to 30 vote. Despite wide support for the measure (and ridicule for the 30 Republicans who opposed it) both the Obama administration's Department of Defense and Chairman Inouye raised concerns while the legislation was being considered in conference committee. Attempts to strip it of the Title VII provision were met with public outcry, which a Senate source familiar with the negotiations says was partially responsible for its ultimate passage.

"The public support surprised a lot of senators and not just the chairman," said the source. "The White House was working with Franken's office to find language that would be enforceable... and I think by the time those talks began everyone was on board, including Chairman Inouye."

Two of the country's largest labor groups, the SEIU and the AFL-CIO, are each holding emergency executive meetings today to discuss whether they should support the latest round of health care compromises made by Senate Democrats.

Though there's no official word yet, early indications based on talks with various officials are that the groups will either formally oppose the legislation or, less dramatically, just not fight very hard to ensure its passage.

Labor leaders are fuming at the concessions that Democratic leadership made in the last few days to win the support of the caucus's most conservative members, notably Sen. Joseph Lieberman (I-Conn.). A bill that already included one highly objectionable provision (a tax on so-called Cadillac insurance plans) was stripped of a provision beloved by labor: a public alternative to private insurance coverage. Frustration boiled over even further after the leadership succumbed to Lieberman's demand to jettison even the compromise to the public option -- a proposal to expand Medicare to those as young as 55.

Together, the changes have spurred emotional internal debates about the approach labor should take to the Senate bill. Dennis Rivera, the Health Care Chair at the SEIU, was slated to appear at a Capitol Hill press conference on Wednesday to push for senators not to filibuster reform. He pulled out from the event, which was sponsored by the pro-reform group Families USA, because of uncertainty about the union's position.

"We just couldn't do it," said an SEIU official. "We haven't even seen the manager's amendment... At this point, we have to make the final decision about how to proceed. There is an emergency meeting tonight to figure that out."

The AFL-CIO, likewise, is hosting an executive council meeting to discuss the legislation. Richard Trumka, the president of the union conglomerate, has been one of the foremost champions of a public plan. And on Tuesday, one of his close allies, Leo Gerard, the president United Steelworkers Union, hinted that opposition to the bill is in the offing.

"I believe that the House [of Representatives] has got a good bill," Gerard told MSNBC's Ed Schultz. "Hopefully it is going to have to go to committee, we're going to fight like crazy to make sure that we get a good bill. I'm not prepared to give up. I want to fight and get a good bill out of this. The American people deserve this and President Obama, whose values are right, he deserves this."

Labor's stance could have big ramifications. Progressive Senate Democrats held their noses as the legislation was watered down at the behest of Lieberman and others. Off the Hill, however, former Democratic National Committee chair Howard Dean called for the current Senate proposal to be "killed" -- and others echoed his concerns.

The labor community has already poured massive resources into the health care debate. Now there is a growing concern that the money and time may have not been well spent. As one high-ranking labor official emailed the Huffington Post:

"What is really frustrating folks here is that it's impossible to make and implement plans to pressure senators when the White House and Reid keep undermining the efforts no one from the outside can put any credible pressure on Senators because they know the White House will back that Senator up whatever they do. If the White House is going to cave to a Senator who spent the entire election campaigning with McCain and calling Obama a traitor how are we supposed to have any leverage over anyone?

"If Lieberman -- who has done so many horrible things directly to Obama -- can get away with this on Obama's signature issue it makes it infinitely harder for us to pressure senators, on issues in the future, because there is no fear of retribution or coercion from the White House. They only pressure progressives, not anyone in the middle."

White House Press Secretary Robert Gibbs insisted on Tuesday that the president has been consistent in demanding that both moderates and progressives within the Democratic Party make policy sacrifices in an effort to pass comprehensive health care legislation.

Speaking to reporters hours after the president met with nearly the entire Democratic caucus, Gibbs said that Obama urged everyone to rally around the remaining components of reform, which, he noted, were historic in their own right.

"The president believes that whether you are on the left of the Democratic spectrum or the right of the Democratic spectrum in the Senate, or concerned about health care in this country, that there is plenty to like in this legislation," said Gibbs.

Asked if Obama is as demanding of Sen. Joseph Lieberman (I-Conn), whose opposition to a public option and Medicare buy-in provision led to their removal, as he has been of progressives like Sens. Sherrod Brown (D-OH) and Tom Harkin (D-Iowa), both staunch supporters of a public plan, Gibbs affirmatively replied: "Yes."

"The president was clear with members of the democratic caucus, including independents who caucus with the Democrats," he said.

Such a depiction of the legislative process would likely come as a surprise to liberals both in and outside of office, many of whom point to the various, watered-down versions of reform to which they agreed in hopes of winning Lieberman's vote. One of those liberals, former DNC Chair Howard Dean, said on Tuesday that the leadership had acquiesced too much to win moderate votes and called on the party to "kill the bill."

Asked about Dean's remarks, Gibbs declined to argue medicine with the doctor. But he "would argue policy with him."

"In 2004, Howard Dean as a candidate sought to build off an employer-based health care system in order to cover millions of Americans that currently lack coverage," said Gibbs. "There are two differences between what the president is doing in 2009 and what Howard Dean proposed in 2004. The first difference is we have an increase in the number of uninsured. The second biggest difference is... the bill is paid for, the bill reduces the deficit, the bill bends the cost curve, the bill adds insurance reforms."

Senate Majority Whip Dick Durbin (D-Ill.) told reporters on Tuesday that he believes health care reform has the votes to pass the Senate before Christmas after Democrats removed a provision to expand Medicare coverage.

"It is my understanding that, at this point it is going to be changed and removed," Durbin said the proposal to allow people between 55 and 64 to buy Medicare. "I think we are very close. We are still working with a few senators who have not made a commitment and until those commitments and votes are made we are going to keep working... Ultimately, we will pass it before Christmas."

The Illinois Democrat, speaking to reporters after a nearly full caucus meeting with President Obama, said he did not believe liberal members of the party would vote against the legislation, despite the absence of a public option or the Medicare buy-in provision.

"They are not happy," he acknowledged. "I'm not happy. I don't like the way this has progressed." But he stressed that there are enough important components in the bill to make passage vital. In particular, he cited bending the cost curve in the health care system, reducing the cost of health care premiums insuring more than 30 million currently uninsured people and strengthening the patient's bill of rights.

Asked by the Huffington Post to respond to former DNC Chairman Howard Dean's call for the bill to be "killed" -- replaced by something more progressive that could be passed through reconciliation -- Durbin replied:

"I disagree with Dr. Dean. I think if he would sit back and look at 31 million Americans who would have health insurance as a result of this bill. How do you say to them: 'Sorry you can't have health insurance. We think this bill can be better.'"

Pressed whether the changes made by Democrats to the legislation would gain the support of any moderate Republicans, he added: "I hope we will. It will be a great Christmas gift."